10/9/2023 EnchantaVaughn Approved (AM) Upon arrival, client was not in a good mood. Client did not look ready for class, as evidenced by his hesitation and lingering in the hallway. Client had one on one with QMHP to talk about his morning and debrief. Client was asked how he was feeling. Client stated he was tired and overwhelmed. Client communicated he did not get a lot of sleep this past weekend and that there was a lot going on at home. Client did not appear to be on medication but he claimed he took it this morning. Client was encouraged to try to make the most of it and take it easy. Client nodded his head and said okay. Client could not handle sitting in his seat and completing the instructed activity. Client was not interested in doing any work and began playing and talking at his desk. Client displayed attention-seeking behaviors at this time to get out of class, hoping to sit with his counselor all day. Client had a difficult time being in class for the duration of the day. Teacher put him out of class several times for talking and being disruptive. Client was careless and unbothered by his consequences. Client was defiant of QMHPs prompts 4-5 times. Client blamed others for his negative behaviors and appeared unapologetic for participating in disruptive actions. Client required 1-2 prompts of redirection before he followed through. Client was prompted to refocus 3-4 times by QMHP. Client was hyper aggressive in group setting and needed some alone time, symptoms which directly correlate to his current diagnosis of Attention Deficit Hyperactive Disorder. Client displayed restlessness and was unfocused during group. Client became increasingly non-compliant with prompts and directives given by both mental health professionals. Client displayed restless displays of behaviors even after one on one. Client processed his feelings and started to make better choices. Client decided to draw pictures of his favorite places and this activity put him in a better mood. (PM) Although, client has been with his counselor for most of the day, counseling has benefited him and given him a space to reflect and cool off. Client stayed with his counselor during lunch to prevent any misbehavior or giving his teacher a hard time. Client feels his teacher do not want him back in class. Client was encouraged to think about ways to apologize for his mistakes without verbalizing it. Client was supported with turning his day around. Client did a good job reducing his aggressive behaviors and being less upset over nothing. Client has maintained appropriate conduct on stage and helping others who needed help. Client is a huge role model for the younger peers and is expected to act like a leader. Client was sent to speak with his teacher about returning back to class after lunch. Client was afraid his teacher would say no. Client understands that it is his responsibility to be in class, despite them only studying and reviewing for the SOL. Client was reminded that studying and practicing for the SOL is just as important as taking the test. Client struggles with coping with stressors and staying alert in class. Client is often distracted by his own thoughts. Client's teacher gave him a choice to come back in class and listen and pay attention or sit in the office. Teacher was not happy with client choosing to stay out of class all day. Client was reasurred that his teacher wants the best for him and is there to help him. Client is encouraged to reach out to his teacher when he has a problem and to be open about how he feels. Client was able to take in the positive encouragement and act more responsibly. Client went into class willing and ready to learn. (EOD) Client was acceptive to redirection and returned to class in a cooperative manner. Client was able to let go of unwanted feelings and show respect to group by participating and acknowledging positive feedback. Client is observed displaying good behaviors. Client was able to reframe from impulsive, hyperactive behaviors until dismissal. Client utilized the last part of his day to catch up on the review and to organize his testing material so that he could finish studying at home. Client expressed good communication and was applauded for being in class and on task. Client hugged QMHP before leaving, displaying a great attitude. Client was unable to succesfully obtain his objectives today, as observed.